Provider Demographics
NPI:1588961288
Name:WEATHERBEE, DARLA DALLISON (RPH)
Entity type:Individual
Prefix:MRS
First Name:DARLA
Middle Name:DALLISON
Last Name:WEATHERBEE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 COUNTY ROAD 8160
Mailing Address - Street 2:
Mailing Address - City:RIENZI
Mailing Address - State:MS
Mailing Address - Zip Code:38865-9375
Mailing Address - Country:US
Mailing Address - Phone:662-808-3617
Mailing Address - Fax:
Practice Address - Street 1:134 COUNTY ROAD 8160
Practice Address - Street 2:
Practice Address - City:RIENZI
Practice Address - State:MS
Practice Address - Zip Code:38865-9375
Practice Address - Country:US
Practice Address - Phone:662-808-3617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-16
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE08813183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist